青年自发性进行性血气胸的治疗策略探索  

Treatment strategy for progressive spontaneous hemopneumothorax in young adults:An exploratory study

作　　者：王伟[1] 方丹青[1] 李东耀 熊新明[1] 杨鑫[1] Wang Wei;Fang Danqing;Li Dongyao;Xiong Xinming;Yang Xin(Department of Thoracic Surgery,Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院胸外科,广州510260

出　　处：《中华生物医学工程杂志》2021年第3期294-297,共4页Chinese Journal of Biomedical Engineering

基　　金：广东省科技计划项目(2017ZC0248,2013B021800315)。

摘　　要：目的研究青年自发性进行性血气胸出血来源,探索最佳治疗和预防对侧血气胸的策略。方法对119例患者行胸腔镜手术,观察出血来源。CT发现对侧有肺大疱,则建议预防性切除。对行预防性手术组和未行预防性手术组随访,分析该侧血气胸发生率。结果出血均是胸膜顶异常血管断裂引起。64例预防性对侧肺大疱切除术和52例未行预防性手术患者,该侧血气胸发生率分别是0和9.6%,差异有统计学意义(P<0.05)。结论青年自发性进行性血气胸出血原因是胸膜顶异常血管断裂。胸腔镜手术是有效的治疗手段,预防性切除对侧肺大疱可预防对侧血气胸发生。Objective To investigate the source of bleeding in progressive spontaneous hemopneumothorax in young adults,and to explore the optimal strategy for treatment of the lesions and prevention against contralateral hemopneumothorax.Methods Thoracoscopy was performed in 119 patients to identify the source of bleeding.Contralateral bullae,if shown on CT,were recommendably subjected to prophylactic resection.The prophylactic surgery and non-prophylactic surgery groups were followed up for incidence of contralateral hemopneumothorax.Results The bleeding was caused by rupture of abnormal blood vessels in the apical pleura.In 64 patients with prophylactic resection of the contralateral bullae and 52 without,the incidence rates of contralateral hemopneumothorax were 0 vs 9.6%,respectively,with statistically significant difference(P<0.05).Conclusions The cause of bleeding in progressive spontaneous hemopneumothorax in young adults is rupture of abnormal blood vessels in the apical pleura,for which thoracoscopic surgery is an effective treatment.Prophylactic resection of contralateral bullae may prevent occurrence of contralateral hemopneumothorax.

关 键 词：自发性血气胸 青年 肺大疱 胸腔镜手术 

分 类 号：R655[医药卫生—外科学]